HEALTH-CLOUD-ACCREDITED-PROFESSIONAL Practice Questions

The Discovery Framework in Salesforce Health Cloud is designed to streamline intake and clinical

assessment processes by leveraging configurable and reusable components. Below is a detailed

explanation of the correct options:

Correct Capabilities:

FHIR Question Bank (C):

Health Cloud supports the integration of FHIR (Fast Healthcare Interoperability Resources) standards

for clinical data management.

The FHIR Question Bank allows healthcare organizations to utilize predefined, standards-compliant

question sets for assessments. This ensures uniformity and compliance with healthcare regulations.

Digital Signature Capture (D):

Salesforce Health Cloud enables capturing digital signatures to confirm the completion and accuracy

of assessments, which is often required for compliance or legal documentation.

Using Previously Submitted Responses (E):

Health Cloud supports dynamic assessments that can reference and reuse responses from previously

submitted assessments. This enhances efficiency, prevents redundancy, and reduces patient burden.

Why Other Options Are Incorrect:

A. Adding a QR Code:

QR codes are not a standard out-of-the-box feature for assessments in Salesforce Health Cloud.

While QR codes can be custom-implemented, they are not directly relevant to the Discovery

Framework.

B. SMS Assessment Completion:

SMS-based assessment completion is not an out-of-the-box feature of Health Cloud. It requires

customization or integration with third-party messaging solutions to achieve this functionality.

Reference:

Administer Health Cloud

Salesforce Health Cloud Documentation on FHIR and Clinical Assessments

Salesforce Discovery Framework Overview

Implementing Home Health scheduling in Salesforce Health Cloud requires assigning appropriate

permission set licenses to users responsible for scheduling patient visits.

Field Dispatch Scheduler Permission Set License:

The Field Dispatch Scheduler permission set license is designed for users who manage and schedule

field service operations, including home health visits. Assigning this license grants schedulers access

to functionalities necessary for coordinating and dispatching healthcare providers to patient

locations. This includes capabilities such as:

Scheduling Visits: Schedulers can create and manage appointments for initial assessments and

recurring visits, ensuring that patients receive timely care.

Salesforce

Resource Management: Effectively allocate healthcare providers based on availability, location, and

required skills to meet patient needs.

Access to Field Service Tools: Utilize tools within Salesforce to optimize routing, manage workloads,

and monitor service delivery.

By assigning the Field Dispatch Scheduler permission set license, Bloomington Caregivers ensures

that their scheduling personnel have the necessary access to efficiently coordinate home health

services, thereby enhancing operational efficiency and patient satisfaction.

Reference:

Schedule Visits with Home Health

Home Health

To display patient information from both Salesforce standard objects and external systems on the

patient record page in Health Cloud, the most efficient approach involves leveraging declarative tools

from OmniStudio, such as Integration Procedures, FlexCards, and DataRaptors. These tools enable

seamless integration and visualization of data across systems.

1. Integration Procedures (Answer B):

Purpose:

Integration Procedures are server-side processes used to retrieve, transform, and orchestrate data

from Salesforce and external systems. They are ideal for connecting to external APIs or databases to

fetch real-time patient data.

Key Features:

Retrieve data from multiple sources, including Salesforce objects and external APIs.

Perform transformations and calculations before presenting the data.

Execute multiple actions in a single server call for improved performance.

Implementation Steps:

Design Integration Procedure: Configure actions to fetch data from standard Salesforce objects and

external systems via REST or SOAP API.

Connect External Systems: Use the External Services framework or Apex adapters to call external

APIs.

Output Data: Structure the data to be consumed by a FlexCard or a Lightning Web Component (LWC).

Reference:

Integration Procedures Overview

2. FlexCards (Answer D):

Purpose:

FlexCards are reusable, lightweight UI components that display data from Salesforce and external

systems. They provide a framework for creating dynamic and interactive visualizations on record

pages.

Key Features:

Aggregate data from multiple sources into a single, cohesive view.

Include actions like navigation, editing, or triggering Integration Procedures.

Display related data in context using customizable layouts.

Implementation Steps:

Design the FlexCard: Use the FlexCard Designer in OmniStudio to build the component with fields

and actions.

Bind Data Sources: Link the FlexCard to the data fetched by the Integration Procedure.

Deploy on Patient Record Page: Add the FlexCard to the Lightning App Builder for the patient record

page.

Reference:

FlexCards Overview

3. DataRaptors (Answer E):

Purpose:

DataRaptors are declarative tools used to extract, transform, and load data to and from Salesforce

objects. They handle data processing between the database and UI components like FlexCards.

Key Features:

Perform CRUD operations on Salesforce data.

Transform data using formulas, mappings, and default values.

Simplify interactions with Salesforce objects for components like FlexCards.

Implementation Steps:

Configure DataRaptors: Set up DataRaptor Extracts to pull data from Salesforce standard objects and

DataRaptor Loads to save updates.

Integrate with FlexCards: Use the output of DataRaptors as input to FlexCards for dynamic data

presentation.

Reference:

DataRaptors Overview

Why Other Options Are Less Relevant:

A. Salesforce Flows:

While Flows are powerful for automation and guided processes, they are not optimized for

displaying real-time, integrated data from external systems on a record page.

C. Visualforce Pages:

Visualforce is a legacy framework with limited flexibility compared to modern tools like FlexCards

and LWCs. It is not recommended for new implementations in Health Cloud.

Conclusion:

By combining Integration Procedures, FlexCards, and DataRaptors, Bloomington Caregivers can

efficiently display patient information from Salesforce standard objects and external systems on the

patient record page. This approach ensures a seamless user experience and streamlined data

integration.

Reference for Further Reading:

OmniStudio Guide

Data Integration in OmniStudio

The Benefits Verification component in Salesforce Health Cloud is designed to help agents respond to

member inquiries regarding benefits coverage. This feature integrates seamlessly with Health Cloud

objects and data, offering agents real-time access to benefit information.

Key Features of Benefits Verification:

Real-Time Verification: Displays benefits data retrieved through integrations, allowing agents to

answer member questions promptly.

Comprehensive Coverage Details: Includes plan benefits, covered services, and limits.

Customizable Layout: Can be configured on the record page to provide relevant benefit details in a

user-friendly format.

Why Other Options Are Incorrect:

A . Eligibility Validation: Focuses on determining program eligibility rather than detailed benefits

coverage.

B . Benefits Coverage: While related, it is not the specific tool designed for verifying benefits

inquiries.

C . Coverage Confirmation: Typically used for confirming specific services under a plan, not general

benefits questions.

Reference:

Benefits Verification in Health Cloud

In Salesforce Health Cloud, to track a patient's relationships with multiple healthcare providers such

as a cardiologist, primary care physician, and oncologist, the Patient Provider Relationship object is

the appropriate choice.

Understanding the Patient Provider Relationship Object:

Purpose:

The Patient Provider Relationship object is designed to represent and manage the associations

between patients (contacts) and their healthcare providers (practitioners).

It facilitates the documentation of various roles that providers play in a patient's care, enabling a

comprehensive view of the patient's healthcare network.

Functionality:

This object allows healthcare organizations to record and monitor the specific relationships between

patients and providers, including details such as the type of care provided, duration of the

relationship, and any relevant notes.

By utilizing this object, organizations can ensure accurate and up-to-date records of all healthcare

professionals involved in a patient's care, supporting coordinated and efficient care delivery.

Implementing Patient Provider Relationships:

Configuration Steps:

Define Relationship Types:

Customize the relationship types to reflect various provider roles, such as cardiologist, primary care

physician, and oncologist.

Establish Relationships:

For each patient, create records in the Patient Provider Relationship object to link them with their

respective providers, specifying the role and any pertinent details.

Maintain and Update Records:

Regularly update these relationships to reflect any changes in the patient's care team, ensuring that

the information remains current and accurate.

By leveraging the Patient Provider Relationship object, healthcare organizations can effectively

manage and visualize the network of providers associated with each patient, enhancing care

coordination and patient outcomes.

Reference:

Provider Relationship Management | Salesforce Health Cloud Developer Guide

Track Complex Household Roles and Relationships in Health Cloud

In Salesforce Health Cloud, managing prior authorizations involves utilizing specific objects designed

to handle the complexities of authorization requests and their associated details. For an insurance

provider aiming to display preauthorization outcomes from an external system that manages the

end-to-end prior authorization process, the appropriate solution involves the Service Preauth and

Preauth Detail objects.

Service Preauth Object:

Purpose: The Service Preauth object represents a preauthorization request within Health Cloud. It

serves as a container for all relevant information pertaining to a specific authorization, including

patient details, requested services, and status updates.

Integration Capability: This object is designed to integrate with external systems, allowing for the

seamless import and display of preauthorization outcomes managed outside of Salesforce. By

mapping external authorization data to the Service Preauth object, users can view and manage

authorization statuses directly within Health Cloud.

Preauth Detail Object:

Purpose: The Preauth Detail object stores detailed information related to each preauthorization

request captured in the Service Preauth object. This includes specifics about the services or

procedures being authorized, such as service codes, descriptions, quantities, and any other pertinent

details.

Integration Capability: By populating the Preauth Detail object with data from external systems,

Health Cloud users gain comprehensive visibility into the components of each authorization request,

facilitating informed decision-making and efficient care coordination.

Integration Process:

To effectively display preauthorization outcomes from an external system within Health Cloud,

consider the following steps:

Data Mapping: Establish a data mapping strategy to align fields from the external system with the

corresponding fields in the Service Preauth and Preauth Detail objects. This ensures that all relevant

information is accurately captured and displayed within Health Cloud.

Data Import: Utilize Salesforce's data import tools or integration middleware (such as MuleSoft) to

import preauthorization data into the Service Preauth and Preauth Detail objects. This process can be

automated to ensure real-time or near-real-time updates, providing users with the most current

information.

User Access and Permissions: Configure user permissions to ensure that appropriate personnel have

access to view and manage preauthorization information. This includes setting up profiles and

permission sets that grant access to the Service Preauth and Preauth Detail objects.

Reference:

Authorization Request Overview: This Salesforce Help article provides an overview of managing

authorization requests within Health Cloud, detailing the objects and processes involved.

Salesforce

Built-In MuleSoft Integration to Manage Authorization Requests: This resource outlines how to

integrate Health Cloud with external Electronic Health Record (EHR) and payer systems using

MuleSoft, facilitating seamless data exchange for authorization requests.

Salesforce

Care Services Review and Response: This developer guide section discusses RESTful APIs that support

data elements required for ANSI X12 278 format Health Care Services Review and Response,

enabling electronic receipt of prior authorization requests from providers.

Salesforce Developers

By leveraging the Service Preauth and Preauth Detail objects, along with appropriate integration

strategies, insurance providers can effectively display and manage preauthorization outcomes from

external systems within Salesforce Health Cloud, enhancing operational efficiency and improving

patient care coordination.

Utilization Management is a critical component in healthcare that focuses on ensuring the

appropriateness, necessity, and efficiency of healthcare services. For payers working with plan

members and medical providers, the case-by-case review of care appropriateness requires thorough

processes to streamline authorization and review tasks.

Designing Care Requests to Seek Authorization (Answer B):

Purpose: The Care Request object in Health Cloud is essential for seeking authorizations from a

health plan for specific healthcare services, drugs, or admissions. This object ensures that requests

are appropriately documented and tracked.

Functionality:

It allows users to create and manage care requests linked to plan members.

Integrates with payer systems to capture critical details for authorization, such as service codes, plan

information, and medical necessity documentation.

Supports automation through workflows and approvals, speeding up the decision-making process.

Relevance: By designing efficient Care Requests, the consultant ensures that all required details for

preauthorizations or service reviews are captured seamlessly, meeting regulatory and operational

needs.

Considering Request Review Types (Answer C):

Purpose: UM processes in Health Cloud must address the three primary types of reviews:

Prior Authorization Review: Conducted before the service is provided to determine medical

necessity.

Concurrent Review: Evaluates the necessity of ongoing care during hospitalization or service delivery.

Retrospective Review: Analyzes the appropriateness of care after it has been delivered.

Implementation in Health Cloud:

The consultant must design workflows and data models to capture the details of these review types,

including timestamps, reviewer notes, and outcomes.

Health Cloud supports tracking and documenting these reviews within the UM module, ensuring

compliance with healthcare regulations.

Relevance: These review types allow the payer to influence decisions by ensuring appropriate care is

provided while managing costs and maintaining high-quality outcomes.

Why the Other Options Are Less Relevant:

A . Designing Next Best Action and Recommendations for the Care Management Team: While

recommendations and next-best-action features are beneficial for care management, they are not

directly tied to the case-by-case review process of Utilization Management, which focuses more on

care appropriateness and authorizations.

D . Considering the Number of Intake Agents Using Health Cloud: While operational considerations

like staffing are important, this is not a Utilization Management process. It's a broader organizational

concern unrelated to the core functionality of UM in Health Cloud.

Reference:

Utilization Management Overview: Salesforce documentation outlines how to handle prior

authorizations, service approvals, and related processes within Health Cloud. (help.salesforce.com)

Care Requests and Authorizations: Details on managing care requests and integrating with payer

systems for streamlined authorization workflows. (developer.salesforce.com)

UM Process Design in Health Cloud: Guidance on implementing request review types and managing

data models to support UM. (architect.salesforce.com)

By addressing Care Requests and Request Review Types, the consultant ensures a robust Utilization

Management setup, enabling effective collaboration between payers, providers, and members while

optimizing care delivery and compliance.

To enable external users to access Provider Search functionality, you need to make necessary

changes to the Experience Cloud site and permissions:

Steps to Enable Provider Search for External Users:

Add the Provider Search Component to the Site (Option A):

Use Experience Builder to include the Provider Search Lightning Web Component on a public-facing

page of the Experience Cloud site.

Steps:

Navigate to Experience Builder.

Drag and drop the Provider Search component onto a designated page.

Publish the site to make the component available to external users.

Grant Read Access to the Care Provider Searchable Field Object (Option C):

External users must have appropriate permissions to view the provider search results.

Steps:

Go to Setup > Profiles.

Edit the site user profile associated with the Experience Cloud site.

Grant Read access to the Care Provider Searchable Field object.

Save and assign the profile to the relevant users.

Additional Notes:

Sharing Rules (Not Necessary): Sharing rules are not required if the external user profile already has

sufficient object-level access.

Data Pipeline Object (Not Relevant): The Data Pipeline object is not directly involved in enabling

Provider Search functionality for external users.

Reference:

Enable Provider Search in Health Cloud

Experience Cloud for Health Cloud

To effectively recruit, credential, and onboard providers into its network, a payer should utilize the

Provider Network Management add-on in Salesforce Health Cloud.

Understanding Provider Network Management:

Purpose: Provider Network Management (PNM) is designed to streamline the processes of

recruiting, enrolling, credentialing, and managing healthcare providers within a payer's network. It

enhances operational efficiency, ensures compliance, and improves provider satisfaction.

Key Features:

Provider Enrollment: Facilitates efficient registration and recruitment of providers, reducing

onboarding time and enhancing engagement.

Credentialing: Supports verification and validation of provider qualifications, ensuring that only

qualified professionals join the network.

Contract Management: Manages various contract types and network models, accommodating

diverse provider relationships.

Network Adequacy: Assists in constructing effective provider networks to meet patient needs and

regulatory requirements.

Implementation Steps:

Acquire the Provider Network Management Add-On:

Ensure that your Salesforce Health Cloud instance includes the PNM add-on, which is available in

Enterprise and Unlimited editions.

Configure Provider Enrollment Processes:

Set up workflows for provider recruitment and registration, utilizing PNM's enrollment features to

streamline the process.

Establish Credentialing Protocols:

Implement credentialing workflows to verify provider qualifications, leveraging PNM's integration

capabilities for primary source verification.

Manage Contracts and Networks:

Utilize PNM's contract management tools to handle various contract types and maintain an

organized provider network.

Reference:

How Provider Network Management Works: For a comprehensive overview of PNM's functionalities,

refer to Salesforce's official documentation: How Provider Network Management Works

Get to Know Provider Network Management: To understand the setup and configuration of PNM,

consult: Get to Know Provider Network Management

Conclusion:

By implementing the Provider Network Management add-on, payers can effectively recruit,

credential, and onboard providers, thereby enhancing network efficiency, ensuring compliance, and

improving overall provider satisfaction.

When launching a patient portal with contact tracing functionality as part of a Health Cloud

implementation, it's crucial to select a license that supports advanced sharing capabilities and

customizable dashboards for external patient users. The Customer Community Plus for Health Cloud

license is the most appropriate choice to meet these requirements.

Key Features of Customer Community Plus for Health Cloud:

Advanced Sharing: This license offers advanced sharing capabilities, allowing for more granular

control over data access. This ensures that patients can securely access their health information

while maintaining compliance with privacy regulations.

Customizable Dashboards: With this license, users have access to customizable dashboards, enabling

the presentation of personalized health data, appointment schedules, and other relevant

information in an intuitive and user-friendly interface.

Enhanced Permissions: Customer Community Plus provides enhanced permissions compared to the

standard Customer Community license, including the ability for users to manage their own records

and collaborate more effectively with healthcare providers.

Considerations:

User Access Requirements: Assess the specific needs of your patient users, including the types of

data they need to access and the level of interaction required within the portal. Customer

Community Plus supports more complex use cases involving data sharing and collaboration.

Compliance and Security: Ensure that the chosen license aligns with healthcare compliance

standards, such as HIPAA, to protect patient information. The advanced sharing and security features

of Customer Community Plus support adherence to these regulations.

Reference:

Experience Cloud for Health Cloud FAQ: This Salesforce Help article provides detailed information

about the capabilities and features of Experience Cloud licenses tailored for Health Cloud, including

advanced sharing and dashboard customization.

Salesforce

Editions & Pricing - Health Cloud: This Salesforce pricing page outlines the different Health Cloud

editions and their features, helping to determine the most suitable license for your needs.

Salesforce

By selecting the Customer Community Plus for Health Cloud license, Bloomington Caregivers can

provide their external patient users with a robust and secure portal experience, featuring advanced

data sharing and customizable dashboards that enhance patient engagement and satisfaction.